Korean J Gastroenterol.  2015 May;65(5):316-320. 10.4166/kjg.2015.65.5.316.

Portal Vein Thrombosis with Sepsis Caused by Inflammation at Colonic Stent Insertion Site

• Choi SJ
• Min JW
• Yun JM
• Ahn HS
• Han DJ
• Lee HJ
• Kim YO

• KMID: 2373229
• DOI: http://doi.org/10.4166/kjg.2015.65.5.316

Abstract

Portal vein thrombosis is an uncommon but an important cause of portal hypertension. The most common etiological factors of portal vein thrombosis are liver cirrhosis and malignancy. Albeit rare, portal vein thrombosis can also occur in the presence of local infection and inflammation such as pancreatitis or cholecystitis. A 52-year-old male was admitted because of general weakness and poor oral intake. He had an operation for colon cancer 18 months ago. However, colonic stent had to be inserted afterwards because stricture developed at anastomosis site. Computed tomography taken at admission revealed portal vein thrombosis and inflammation at colonic stent insertion site. Blood culture was positive for Escherichia coli. After antibiotic therapy, portal vein thrombosis resolved. Herein, we report a case of portal vein thrombosis with sepsis caused by inflammation at colonic stent insertion site which was successfully treated with antibiotics.

Keyword

Portal vein thrombosis; Sepsis; Anti-bacterial agents; Inflammation

MeSH Terms

Anti-Bacterial Agents/therapeutic use
Cholecystitis/etiology
Colonic Neoplasms/pathology/therapy
Escherichia coli/isolation & purification
Escherichia coli Infections/drug therapy/etiology
Humans
Inflammation/*etiology
Liver/diagnostic imaging
Male
Middle Aged
Pancreatitis/etiology
Portal Vein
Sepsis/*diagnosis/drug therapy/microbiology
Sigmoidoscopy
Stents/*adverse effects
Tomography, X-Ray Computed
Venous Thrombosis/complications/*diagnosis
Anti-Bacterial Agents

Figure

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  Fig. 1. Abdominal CT scan taken two months before admission. There is no evidence of portal vein thrombosis (arrowhead).

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  Fig. 2. Abdominal CT scan at admission. (A) Portal vein thrombosis (arrowhead) is present in left portal vein. (B) Inflammatory fibrotic stricture is seen at anastomosis site but stent patency is maintained in de-scending colon (arrow).

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  Fig. 3. Sigmoidoscopy findings. Inflammation is not evident at anastomosis stricture site where colonic stent had been inserted.

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  Fig. 4. Follow-up abdominal CT scan. (A) Abdominal CT scan taken after 1 month shows improved portal vein thrombosis (arrowhead). (B) After 2 months, regression of portal vein thrombosis (arrow) and moderate amount of ascites are noted.

Reference

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